Simon
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Effects of early childhood trauma on hypothalamic–pituitary–adrenal (HPA) axis function in patients with Chronic Fatigue Syndrome -
Psychoneuroendocrinology - Kempke Feb 2015
ABSTRACT
BACKGROUND:
There is a paucity of studies that have investigated the assumption that early childhood trauma is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in Chronic Fatigue Syndrome (CFS). The current study is the first to simultaneously investigate relationships among early childhood trauma, cortisol activity, and cortisol stress reactivity to psychosocial stress in a sample of well-screened CFS patients. We also examined whether self-critical perfectionism (SCP) plays a mediating role in the potential relationship between early trauma and neurobiological stress responses.
METHODS:
A total of 40 female patients diagnosed with CFS were asked to provide morning saliva cortisol samples (after awakening, 30min later, and 1h later) for seven consecutive days as a measure of cortisol activity. In addition, patients were exposed to the Trier Social Stress Test, a well-validated stress test, to investigate the relationship between early childhood trauma and cortisol stress reactivity. Before the start of the study, patients completed the Childhood Trauma Questionnaire-Short form (CTQ-SF) as a measure of early childhood trauma (i.e. sexual, physical and emotional traumatic experiences). SCP was measured with the Depressive Experiences Questionnaire (DEQ). Data were analyzed by calculating several indices of cortisol secretion (i.e. Cortisol Awakening Response and Area Under the Curve).
RESULTS:
There was no association between early childhood trauma and cortisol as measured over the 7-day period. However, emotional neglect was significantly negatively related to cortisol reactivity in the TSST. SCP did not significantly mediate this association.
CONCLUSION:
Findings of this study suggest that emotional neglect is associated with blunted HPA axis reactivity, congruent with the assumption that CFS may reflect loss of adaptability of the neuroendocrine stress response system in at least a subgroup of patients.
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First off, in my view this is a perfectly reasonable study to run. There is some evidence of a link between childhood trauma and CFS (though it's compromised by issues over diagnosis and case definition, and at best would only explain a minority of cases). The idea is that childhood trauma affects the HPA axis which in turn increases the risk of a number of illness - mostly psychological, they say, but some physical too. They set out to see if daily cortisol levels (cortisol is a stress hormone intimately involved in the HPA axis) were linked to childhood trauma in a sample of 40 adolescent patients. In particular they wanted to see if cortisol response was blunted (diminished) both on waking in the morning (when it naturally increases) and in response to a stress test - as a way of seeing if the HPA axis wasn't working as it should. So far, so good.
However, they made a series of findings that undermined their theory, yet still concluded the theory was supported. Which made me wonder what the purpose was of doing the research.
... continued below
Psychoneuroendocrinology - Kempke Feb 2015
Decent study but reporting of findings are wishful and overstate case
Actually, think it would be more accurate to say that this study provided significant evidence against the idea that childhood trauma plays a role in CFS via HPA axis dysfunction. I will try to explain why I think the authors have missinterpreted their findings, but first the full abstract:Study conclusion said:Findings of this study suggest that emotional neglect is associated with blunted HPA axis reactivity, congruent [consistent] with the assumption that CFS may reflect loss of adaptability of the neuroendocrine stress response system in at least a subgroup of patients.
ABSTRACT
BACKGROUND:
There is a paucity of studies that have investigated the assumption that early childhood trauma is associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction in Chronic Fatigue Syndrome (CFS). The current study is the first to simultaneously investigate relationships among early childhood trauma, cortisol activity, and cortisol stress reactivity to psychosocial stress in a sample of well-screened CFS patients. We also examined whether self-critical perfectionism (SCP) plays a mediating role in the potential relationship between early trauma and neurobiological stress responses.
METHODS:
A total of 40 female patients diagnosed with CFS were asked to provide morning saliva cortisol samples (after awakening, 30min later, and 1h later) for seven consecutive days as a measure of cortisol activity. In addition, patients were exposed to the Trier Social Stress Test, a well-validated stress test, to investigate the relationship between early childhood trauma and cortisol stress reactivity. Before the start of the study, patients completed the Childhood Trauma Questionnaire-Short form (CTQ-SF) as a measure of early childhood trauma (i.e. sexual, physical and emotional traumatic experiences). SCP was measured with the Depressive Experiences Questionnaire (DEQ). Data were analyzed by calculating several indices of cortisol secretion (i.e. Cortisol Awakening Response and Area Under the Curve).
RESULTS:
There was no association between early childhood trauma and cortisol as measured over the 7-day period. However, emotional neglect was significantly negatively related to cortisol reactivity in the TSST. SCP did not significantly mediate this association.
CONCLUSION:
Findings of this study suggest that emotional neglect is associated with blunted HPA axis reactivity, congruent with the assumption that CFS may reflect loss of adaptability of the neuroendocrine stress response system in at least a subgroup of patients.
========
First off, in my view this is a perfectly reasonable study to run. There is some evidence of a link between childhood trauma and CFS (though it's compromised by issues over diagnosis and case definition, and at best would only explain a minority of cases). The idea is that childhood trauma affects the HPA axis which in turn increases the risk of a number of illness - mostly psychological, they say, but some physical too. They set out to see if daily cortisol levels (cortisol is a stress hormone intimately involved in the HPA axis) were linked to childhood trauma in a sample of 40 adolescent patients. In particular they wanted to see if cortisol response was blunted (diminished) both on waking in the morning (when it naturally increases) and in response to a stress test - as a way of seeing if the HPA axis wasn't working as it should. So far, so good.
However, they made a series of findings that undermined their theory, yet still concluded the theory was supported. Which made me wonder what the purpose was of doing the research.
... continued below
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